PRP Therapy: One Size Fits All

At the Centeno-Schultz Clinic we acknowledge the important of taking a history, performing a physical examination and reviewing radiographic studies.  We appreciate that MRI’s or x-rays alone rarely identify the source of pain.  Many painful conditions such as facet dysfunction are not reliably detected on conventional radiographic studies.

Some health care facilities have recently advertised PRP treatments through radiology departments without the need for an initial evaluation.  A prospective patient calls, provides a brief history and secures an appointment.  No initial examination is required nor is a complete history  taken.  The platelet rich plasma is injected via guidance and the patient is subsequently discharged with no followup.

We find this treatment lacking on many counts.  In medicine one size does not fit all.  Not all conditions require the same PRP therapy.  In contrast an automated, bedside machine which can only produce a one PRP product, a state of the art lab practice such as the Centeno-Schultz Clinic can customize platelet rich therapy.  Important factors in a patients history are taken into consideration at the Centeno-Schultz Cinic. We have blogged previously on how medications such as statins can complicate certain conditions such tendonitis.  Patients see their physician immediately after the injections to evaluate the immediate results and followup in clinic weeks thereafter to ensure clinical progress.  It is this attention to detail that differentiates the Centeno-Schultz Clinic from others.

PRP Therapy: Critical Differences

Platelet rich plasma (PRP) therapy has gained increasing attention as a non surgical option for musculoskeletal injuries. Platelets are rich in growth factors which mobilize repair cells, promote cell division and accelerate healing.  At the Centeno-Schultz Clinic  PRP has been successful in treatment of elbow, hip, knee and heel  pain( lateral and medial epicondylitis, piriformis syndrome, patellar tendinopathy and Achilles tendinopathy.

 Maximal clinical results  are obtained when  an accurate diagnosis is established, injection of PRP is performed under ultrasound guidance and a labatory prepated PRP is utilized.

 Identifying the source of pain is essential.  Delivery of the platelet concentrate must be directly into the area of damage.  Ultrasound gives direct visualization of the damaged tissue and the where the injected platelets are going.  At the Centeno-Schultz Clinic we have a state of the art laboratory which enables us to prepare a customized platelet concentrate which has a higher number of platelets and less cellular debris than bedside centrifuge units commonly employed by most clinics.

Critical Differences in PRP: Laboratory Prepared vs Bedside

Not all platelet rich plasma (PRP) preparations are the same.   The majority of PRP preparations are created by bedside centrifuge units.  At Regenexx we are constantly striving to improve clinical results.  Our state of the art cellular laboratory enables us to experiment on different ways to get more platelets out of a given sample. 

We recently ran an experiment with 5 patient’s samples trying 5 different techniques to maximize platelet concentration in platelet rich plasma.  A flow cytometer was used to measure the number of platelets being isolated and how ‘clean” the isolation was in the mix..  A clean isolation was preferred since it meant it had little extra platelet matter( cell membranes.)

The results demonstrated that the centrifuge techniques similar to bedside PRP did NOT produce the best platelet concentrates.  In fact, they tended to produce less platelets and more non platelet matter than other techniques. 

A proprietary simple laboratory technique has been developed that provides more platelets and a much cleaner isolation.  It is called APC:  autologous platelet concentration so as to differentiate it from  PRP.  It produced 237% more platelets when compared with traditional bedside centrifuge units.

Below is a graph that demonstrates the significant differences.  The graph on the left has a wide mountain reflective of  significant non platelet matter whereas the graph on the right has a narrow tall peak reflective of a cleaner isolation.  Total number of platelets on the left is 200 vs 12oo produced by the laboratory.

Bottom line:  laboratory prepared autologous platelet concentrate provides a larger number of platelets in a cleaner isolation.  This difference translates to improved healing and faster recovery.